The demand for registered nurses (RNs) across the United States rises steadily every year, exacerbating the pre-existing RN shortage. Low supply and high demand are driving up the average nurse salary, and more people are seeking health-care careers in nursing to benefit from that competitive compensation.
If you are thinking about joining the healthcare industry, then this is a good time to start your medical career. You can get started as a vocational nurse (LVN/LPN) or nursing assistant, then work your way up the ladder as you further your education to qualify for top positions such as nurse practitioner, NICU nurse, travel nurse, school nurse, clinical nurse specialist, nurse educator, ICU nurse, nurse anesthetist, or nurse midwife, among others.
Since there are now countless options to accelerate your studies, you don’t have to worry about taking too much time or having to drop out of your current employment to acquire the necessary nursing training and licensure.
In this article, we will explore the registered nurse career and the salary ranges that registered nurses receive across different states.
Let’s dive right in!
Registered Nurse Salaries by State
Different states across the country offer different nursing salary rates depending on several factors. The highest paying states have higher costs of living and thus the nurse salary in healthcare facilities in these states has to be higher to help nurses offset the high living costs. However, this is not a given for all states. There are some states where the cost of living is high, yet the RN salary remains modest.
States That Offer the Highest Salaries for Registered Nurses
According to a May 2019 report by the U.S. Bureau of Labor Statistics, there were over 2.9 million registered nurses employed in different states across the U.S, with the highest numbers employed in California, Texas, Florida, New York, and Pennsylvania, respectively.
As of May 2019, the following were the highest paying states for registered nurses:
- California – $113,240
- Hawaii – $104,060
- District of Columbia – $94,820
- Massachusetts – $93,160
- Oregon – $92,960
Other high-paying states that also have high employment rates for RNs at the time include:
- New York – $87,840
- Texas – $74,540
- Pennsylvania – $71,410
- Florida – $67,610.
These pay rates are for the average annual salary offered in each state. The salaries indicated exclude three nursing positions including nurse midwife, nurse anesthetist, and nurse practitioner, all of whom command higher rates. California remains the highest paying state for RNs. Some of the other states with high pay for RNs include Alaska, Nevada, Washington, and New Jersey.
National Average for a Registered Nurse’s Salary
The national average salary is arrived at when the salaries for the employed RNs in different states are compared and analyzed. As of 2019, the mean hourly wage for registered nurses was $37.24.
The hourly wage distribution for the 2.9 million RNs studied was as follows:
- 10th percentile: $25.04 per hour
- 25th percentile: $28.90 per hour
- 50th percentile: (median): $35.24 per hour
- 75th percentile: $43.64 per hour
- 90th percentile: $53.47 per hour
The mean annual salary stood at $77,460, which is higher than $51,960 the national annual average salary for all occupations as reported in the same year. The annual salary distribution for more than 2.9 million RNs in employment was as follows:
- 10th percentile: $52,080
- 25th percentile: $60,110
- 50th percentile: (median) $73,300
- 75th percentile: $90,760
- 90th percentile: $111,220.
The most recent reports indicate that the monthly salary for RNs averages $6,129, which is higher than the prevailing $4,218 national average monthly salary for all occupations.
States That Pay Registered Nurses the Lowest Salaries
The lowest paying states for registered nurses are generally concentrated in the Midwest and South. It’s important to note that although these states have the lowest pay, there’s a steady increase in the annual salary, with prospects reaching the average national threshold. A lower pay doesn’t mean the states are less favorable to work in.
The states of South Dakota, Mississippi, Arkansas, Iowa, West Virginia, and Alabama are among the least paying.
Highest-paying Registered Nursing Jobs
The best way to move up the ladder to a top-paying nursing job is to acquire more education. For example, you may consider taking a one-year nurse practitioner program to level up your skills. According to the 2019 career outlook by the U.S. Bureau of Labor Statistics, registered nurses who have higher education, such as nurse-midwives and nurse anesthetists, are in high demand.
The following are some of the highest-paying registered nursing specialties:
1. Gerontological Nurse Practitioner
This profession is one of the fastest-growing nursing careers. It is expected to grow up to 31% in the next ten years because most of the U.S. population is now aging, with the number of adults over 65 years increasing consistently. The aging population needs attentive healthcare. Gerontological nurses earn an average annual salary of $96,460. They find work in hospitals, long-term care facilities, outpatient setups, and offices of physicians.
2. Nurse Educator
Since the healthcare industry is growing rapidly and more people are seeking nursing careers, nurse educators are also in high demand to teach and prepare nursing students for the health industry. Nurses seeking to become nurse educators should complete a doctoral or master’s degree with an accredited institution. The average annual salary for nurse educators ranges between $73,000 and $84,000.
3. Informatics Nurse
With training in information technology and computer science, informatics nurses work with other health industry professionals to manage data integration to help facilities and organizations improve on their patient care systems. An RN license is a requirement. Individuals interested in this career must also have a Bachelor of Science in Nursing (BSN) degree.
4. Emergency Room Nurse
Emergency room nurses work to stabilize and treat illnesses and various traumas that necessitate emergency medical care. This is a highly demanding position that calls for all-around alertness, hands-on preparedness, and the ability to work longer hours in cases of severe emergencies where patients have to be helped to survive different ordeals.
5. Nurse Anesthetist
This is an Advanced Practice Nurse who administers anesthesia and pain medication. During surgeries and recovery periods, they observe patients for critical signs and offer the proper pain management adjustments to alleviate pain in patients. They earn about $181,040 per year as per a 2019 report by the U.S. Bureau of Labor Statistics.
6. Family Nurse Practitioner
A family nurse focuses on family-based healthcare with services such as disease prevention and management and counseling for both patients and family members of the patients. These services are offered in close working relationships with other professionals like doctors. This is a booming sector as more families across the U.S. now embrace having a family doctor or nurse whom they can always look up to for treatment and counseling.
7. Psychiatric Nurse Practitioner
A psychiatric nurse or a Psychiatric Mental Health Advanced Practice Registered Nurse (PMH-APRN) works in places like nursing homes, rehabilitation centers, hospitals, and prisons to administer psychotherapy and prescribe medication following thorough analysis. The patients may either have mental disorders or the potential to develop them.
8. Nurse Midwife
This is one of the most lucrative and fulfilling nursing specialties. Nurse-midwives assist women during childbirth as well as counsel and take care of them in between the preconception, gestation, and postpartum periods. They also diagnose, treat, and write prescriptions for various conditions. Suggesting patient referrals and offering gynecological services are some of the other activities they engage in.
9. Clinical Nurse Specialists
Clinical nurse specialists are APRNs certified to work in specific niches as they choose. They have the expertise and clinical skills required to work in healthcare facilities that offer specialized services such as pediatric and long-term care. They find work as consultants, clinicians, researchers, educators, and leaders or administrators to offer attentive and individualized care to patients. They can choose from specialties such as a geriatric nurse, ICU nurse, neonatal nurse, critical care nurse, pediatric nurse, and perianesthesia nurse.
Types of Hospitals and Facilities That Offer the Highest Salaries to Registered Nurses
There are different types of hospitals, based on the level of medical care provided. Registered nurses can work in any of the following hospital types:
- Primary care hospitals
- Secondary care hospitals
- Tertiary care hospitals
- Quaternary care hospitals
Primary care hospitals offer the first contact point for all medical concerns and include care providers such as nurse practitioners, doctors, or nurse assistants. Some of the specialties here include pediatricians, geriatricians, and gynecologists depending on one’s specific care group.
Primary care providers may refer a patient to a secondary care provider such as an oncologist or cardiologist when more expertise is needed.
Tertiary care providers use special equipment and treatment procedures such as hemodialysis, certain plastic and neurosurgeries, and burns. These services are best offered in large, well-equipped hospitals.
Quaternary care is more specialized and specific for certain medical situations and body systems. It includes unusual and highly specialized surgeries as well as experimental procedures and medications.
Of the four types, registered nurses in primary care hospitals receive the lowest pay. The salary increases with each level of care and tops out at quaternary care hospitals. Advanced experience and expertise are required from RNs working in this category.
A simpler way to classify hospitals based on the type of care is acute versus long-term hospitals. The former provide care for illnesses, injury, disease, or surgery in the short-term. Long-term care hospitals provide care for conditions that take longer such as rehabilitation, chronic illnesses, and psychiatric conditions. Although acute care hospitals are the majority, at around 91%, registered nurses earn more at long-term care hospitals.
For-profit hospitals, which are owned by investors, usually offer registered nurses bigger salaries than not-for-profit hospitals.
Non-community hospitals offer registered nurses bigger salaries than community hospitals that are usually run by local leaders and serve a certain local community. The latter usually have limited financial budgets.
Federal hospitals also offer competitive salaries for registered nurses, but financial burdens may force some to close down and thus pose job stability risks.
Some of the major facilities that pay RNs highly include rehabilitation centers, clinics, pharmacies, outpatient care centers, prisons, schools, and cruise ships.
Certified Registered Nurse Anesthetists Salary
CRNAs are in high demand in pain management and anesthesia. The annual salary for certified registered nurse anesthetists is about $181,040.
Registered Nurse Salaries By Education
Different employers or healthcare facilities employ registered nurses with varying education credentials, but some get the upper hand since they have received more intense training.
How Education Influences a Registered Nurse’s Salary
The registered nurse salary you can command depends on the level of education you have invested in to become an RN. Acquiring further education in nursing enhances your bargaining power to enable you to secure better-paying jobs since most healthcare facilities prefer to enlist the services of any nurse with higher education credentials.
Higher education means that you have an edge over your peers with lower levels because your training is more intensive and expansive. As you level up your nursing education, the training systems change to include more complex studies that enable you to handle equally complex real-life situations at your workplace. Healthcare facilities are ready and willing to pay you more to offer your expertise in dealing with such complex situations that often require more specialized care and attention.
Degrees and Certifications Required to Become a Registered Nurse
A nursing career requires you to fulfill different levels of nursing education to start practicing as a registered nurse within your state or beyond in positions such as a travel nurse.
The following are some of the educational credentials required to become an RN:
1. Licensed Practical Nurse (LPN)
Also known as a licensed vocational nurse (LVN), this level requires you to do a certificate or diploma in nursing before registering for the National Council Licensure Examination for registered nurses.
To reduce the time of the study, you can consider some of the accelerated LPN programs that enable you to get into the labor market earlier.
2. Associate Degree in Nursing (ADN)
An associate degree in nursing usually takes two years and also allows you to get the RN license once you have also completed the NCLEX exam.
3. Bachelor’s of Science in Nursing (BSN) Degree
A BSN degree is currently the most preferred education credential for registered nurses. It is estimated that within the next few years, at least 80% of all RNs will have acquired the BSN degree to continue working in different healthcare facilities.
To make it easy for aspirants to acquire the BSN degree, most nursing schools, colleges, and universities structure their teaching method such that the nursing program they offer allows students to study as they work or to fast-track the degree and complete it in less than four years. The accelerated option means that students have to commit to more intense instruction lessons spread within a condensed timeframe. This can be quite demanding and challenging for most nurses.
For both the accelerated and normal study methods, most schools offer both online and on-campus learning options. However, on-campus learning may be required in most areas since some of the complex, technical modules in nursing require direct in-person learning.
Degrees to Get to Paid the Highest Salary as a Registered Nurse
While the three basic certifications and degrees will get your foot in the door in the nursing career, they do not guarantee earning the best salaries. To command even higher pay, you need to further your education to branch out into specialties that will earn you a higher salary. Some of the specialties you can get into with higher education include emergency room nurse, advanced practice registered nurse, nurse practitioner, nurse educator, and nurse anesthetist.
The two degrees that will enable you to get into different nursing specialties as discussed below:
1. Master’s of Science in Nursing (MSN)
A Master of Science in Nursing allows you to join specialties such as healthcare education, nurse practitioner, and healthcare administration. Here, you can become a nurse educator or take up administrative and leadership roles such as nurse director/manager.
Full-time students typically take two years to complete a master’s degree in nursing. Part-time and work-study learners often take a bit longer to complete the same degree for a period between two to five years. However, many schools offer accelerated MSN programs that students could complete much faster with study durations of up to 18 months.
Students seeking an MSN degree have three options between a non-nursing bachelor’s degree to MSN, RN-to MSN, and BSN-to-MSN.
2. Doctorate of Nursing Practice (DNP)
A doctoral degree in nursing allows you to dive deeper into advanced nursing practice to work in highly specialized clinical settings or take up leadership roles. This is the terminal degree in the nursing career and one that helps you earn the highest pay for your medical and administrative expertise.
Although there is little data to show how much DNP holders earn, recent trends indicate that the average annual salary ranges between $125,000 and $150,000.
Full-time students take three to four years to complete a DNP. As with the MSN, part-time and work-study learners may take up to seven years to acquire the doctorate. However, with fast-tracked online and on-campus DNP options, part-timers may still manage to complete the doctoral degree in four years.
It is important to note that for all these certifications and degrees, you must take and pass the NCLEX exam to get the nursing license. Note also that most employers now prefer BSN educated RNs over LPNs and ASN holders.
Registered Nurse Salaries by Experience
Your level of experience in the nursing career is one of the major factors that influence how much you get paid for your specific role. While most of the time experience is based on the number of years you have worked in the industry, it is worth noting that with the extensive technological advancements in the modern world, it is possible to gain a ton of experience within a shorter time if you are tech-savvy.
You may come across employment opportunities that ask for a registered nurse with at least seven years of nursing experience, but that shouldn’t deter you from applying if you only have a few years under your belt.
Other than the use of technology to keep up with evolving trends in the industry, it also matters how much you expose yourself to opportunities where you can gain experience quickly. For example, you may choose to work in larger hospitals where the career is more demanding than in smaller ones where the need for nursing services may be lower.
How Experience Influences the Average Salary of a Registered Nurse
Based on number of years worked in the healthcare industry, the average RN salary is:
- A registered nurse with less than five years of experience has a median salary of $45,500.
- Registered nurses with 6 to 10 years of experience have an average salary of $55,000.
- RNs with 11 to 15 years of experience make an average salary of $57,300.
- Registered nurses with over 15 years of experience make $63,500 per year on average.
Other factors that may affect your salary based on your experience include the number of years you have worked at the same place and the use of time-based pay scale systems by unionized hospitals. If you have worked a long time at the same institution, your take-home pay may grow over the years as the facility would prefer to keep nurses who are fully conversant with their workplace and its operating systems. This happens because they try as much as possible to avoid disruptions and hiring new workers now and then means altering the routine provision of patient care they are used to.
Some unionized hospitals have shifted from merit-based pay systems to time-based systems such that all registered nurses with similar experience earn the same amount.
The more experience and education you acquire, the higher RN salary you can command.
How Much the Average Registered Nurse’s Salary Increases Each Year
The average annual salary for registered nurses increases between 1% and 3% each year. According to a U.S. Bureau of Labor Statistics report in March 2019, registered nurses had a $71,370 annual median salary for the year between May of 2017 and May of 2018. This was a 3.7% rise in wages in comparison to the previous year. However, the salaries for registered nurses do not rise year after year in some situations or locations. Sometimes it is two to three years before nurses are given a salary raise.
Sometimes, the median salary may decrease. For example, according to PayScale, the average salary for a critical care nurse has decreased by 1% since 2019.
Factors That Influence How Much the Average Registered Nurse Salary Increases Each Year
Several factors determine how much the average salary for a registered nurse increases each year; these include the location, the prevailing economic conditions, acquisition of higher education, years of experience, and the prevailing demand for healthcare, among other factors.
Registered nurses also get higher pay raises if they are working in states with a higher cost of living. Since this cost keeps rising by the year, nurses are eligible for higher pay to offset the increasing cost of living within these locations.
If the prevailing economic environment favors a pay raise for RNs, some employers offer their healthcare workers better salaries. However, some may do the opposite and offer their nurses a pay raise each year even when there is acute economic repression as a measure to ensure they retain them rather than lose them to other potential employers.
Number of Years of Experience Needed to Reach the Highest Registered Nurse Salary Tiers
After pursuing a registered nurse program, it’s important to note that RNs with either an MSN or DNP earn the highest nursing salary. Some of the top-paying positions here include nurse practitioner, nurse educator, nurse midwife, pediatric nurse, a clinical nurse with certain specialties, certified registered nurse anesthetist, among others.
For full-time students, a BSN-to-MSN takes two years while an MSN-to-DNP takes two to three years. For part-timers or work-study students, these durations may go up to four and six or seven years respectively.
Where would you want to be in your nursing career in five years? How much would you like to earn annually by that time? Take the bold step now.